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Apr 21 1509:13a p.1 <br /> Y-y F L'�1 AMERICAN VALLEY i J33^42(; v <br /> r'[ IJL� V WASTE OIL, INC. Invoice Number: <br /> APR 21 2015 P.O.Bax 340 a Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> ENVIRONMENTA! EPA*CALOODS27878 <br /> .re•—, •�•tet-AKJPTAWOODbR-DOE �wA/lP1T1r�t t�NRI{Jl'�k <br /> BILL TO: 18%06 N -OVv ER SAGRAMEN fo t2'- JOB SITE: inn <br /> WCKx'8RI1XiE C- v5,�r ttFu t,��.v[-k .c.:.Ra�arJ4inffi%voiceDate: <br /> :i9 is-5 iwp <br /> Phone=- -33"238jA.SSI Customer P.O. Terms <br /> t, ;.i":. EPARi,A:Dni3:;t_E:52 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTfTY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste <br /> Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Fillers=r <br /> EMPTY M.=I AL URVW DtSf-',:>�i. <br /> DUE fCr THE URAS1Ftp UALL N3 C:RUDE,4, <br /> !'. ES.V*HAVE BLE14 r0R—LU Tf) <br /> -T ANGLPRI(A IGFORVhA3fE. iLANL) <br /> FilzfER <br /> r - <br /> 2'. <br /> TERMS: Invoices over 30 Days ars subJect to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL ,�.. <br /> becomes necessaryto collect this invoice. <br /> By signing I herby certify that have not mixed any of the waste described above with any other hazardous waste,the total halide content is Lr55 than 1,000 ppm, <br /> and the waste does not contain any PCBs.I have complied with the requirements of the applicable California used all management regulation to determine this Is <br /> true.I affee to accept the additional cha rges for the disposal of this was; ,#theinformation I have provided about.this waste is incorrect. <br /> Generator's Certification:By signing I certify that if I am a large quantity generator,I certify that 1 have a program in piece to redurethe volume and toxicity of waste <br /> generated to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently <br /> available tome which minimizes the present and future threat to human Iffe and the environment:Or,if I am a small quantity generator,I have made a good faith <br /> effort to minimize my waste generation and select the waste management method that Is available to me that 1 can afford. <br /> By both parties signing this invoice it vAll serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the generator <br /> that their waste has been transported to a licensed treatment or transfer faci0ty, <br /> DRIVER .GENERATOR/ <br /> S16KATURE t AUTHORIZED <br /> Itl1AT �_.. DATE SIGNATURE: - - DATE <br /> DISPOSAL I RECYCLING F CI ITY <br /> O DK-OIXON ` -CFR O UNITED ENTERPRISES CORP <br /> 7300 CHEVRON WAY 2035 E. 15TH ST. 11190 PENROSE ST. <br /> DIXON,CA 95820 LA,CA 90021 SUN VALLEY,CA 91352 <br /> 707-693-8008 213-746-0237 818-787-2649 <br /> EPAC CAT08MI2602 EPA#CAL000270577 EPA#CAL00037W59 <br /> NPG Ie2rnm <br />